Scott Rosingnol with eHealth Exchange and others will address what providers and payers need to know at HIMSS26.
Scott Rossignol, consultant, FHIR Solutions, eHealth Exchange, is among the speakers addressing the Centers for Medicare and Medicaid Services Interoperability and Prior Authorization Final Rule (CMS-0057) during a session at the 2026 HIMSS Global Health Conference & Exhibition in Las Vegas.
The session is part of the Interoperability & HIE Preconference Forum at HIMSS26.
Most providers and payers are not yet prepared for mandates of the final rule that go into effect in January 2027, Rossignol said.
The final rule, released in January 2024, is reshaping how healthcare organizations, especially payers, handle prior authorizations and data exchange.
The session, “CMS 0057 and ePrior Authorization: What Providers and Payers Need to Know,” is intended to help them prepare.
The impacted payers include Medicare Advantage, Medicaid, CHIP and Affordable Care Act exchange plans. These payers must fully implement key Application Programming Interfaces (APIs), including the Prior Authorization API, Provider Access API and expanded Patient Access API to improve data exchange.
Payers must implement an API that enables providers to submit, and receive, electronic decisions directly within their EHR or practice management systems, Rossignol said.
Key requirements, starting in 2026, included faster prior authorization decisions on the part of payers. The 2027 mandates go beyond those requirements and are challenging to implement, he said.
The session will address how providers are going to transmit data to payers and how payers will respond to the data.
The session is not so much about nuts and bolts of the rule but about pilots Rossignol and others have worked on in the DaVinci space, he said.
The HL7 Da Vinci Project is a private-sector initiative that accelerates the adoption of HL7 FHIR (Fast Healthcare Interoperability Resources) standards to improve data exchange between payers and providers.
“We create pilots to stand up the technologies,” Rossignol said. “You can be successful and save money.”
Rossignol will be speaking with Srihari Muthyala, director, Health Care Solutions and Interoperability Cambia Health Solutions; Anna Taylor, assistant vice president, Population Health & Value Based Care for the MultiCare Health System; and Michael Westover, vice president, Pop Health Informatics Providence, during the session “CMS 0057 and ePrior Authorization: What Providers and Payers Need to Know,” Monday, March 09 at 10:35 a.m. at HIMSS26 in Las Vegas.
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